CN101912414A - Blood purification base displacing liquid - Google Patents
Blood purification base displacing liquid Download PDFInfo
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- CN101912414A CN101912414A CN 201010258220 CN201010258220A CN101912414A CN 101912414 A CN101912414 A CN 101912414A CN 201010258220 CN201010258220 CN 201010258220 CN 201010258220 A CN201010258220 A CN 201010258220A CN 101912414 A CN101912414 A CN 101912414A
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- displacing liquid
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- base displacing
- blood purification
- liquid
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Abstract
The invention discloses blood purification base displacing liquid. Each hundred milliliter of water for injection contains 607.5 to 742.5 milligrams of NaCl, 18 to 22 milligrams of MgSO4 and 22.5 to 27.5 milligrams of CaCl2 which form sugar-free base displacing liquid. Based on a formula of the sugar-free base displacing liquid, 625 to 1,250 milligrams of glucose is added to form sugar-containing base displacing liquid. The blood purification base displacing liquid can meet the requirement of serious patients for continuous blood purification treatment, overcomes the defects of pollution and fussy preparation process caused by preparing the ready-to-use displacing liquid beside a bed, facilitates quick preparation of clinical bicarbonate, realizes personalized treatment, and can effectively avoid complications such as hyperkalemia, lactic acidosis, hyperglycemia and the like and furthest stabilize the internal environment of the patient body.
Description
Technical field
The invention belongs to medical manufacturing technology field, relate to a kind of base displacing liquid, relate in particular to a kind of blood purification base displacing liquid that is applicable to the internal metabolism disorder.
Background technology
For the patient with severe symptoms, especially intensive care unit(ICU) (intensive care unit, ICU) be associated with multiple organ dysfunction syndrome (multiple organ dysfunction syndrome in, MODS) patient, in recent years, utilize continuous blood purification (continuous blood purification, CBP) technology, remove participate in the blood that development takes place MODS cause the damage factor, the downward modulation inflammatory reaction, improve the prognosis final result of MODS, gradually become one of effective means of treatment MODS.
In the continuous blood purification technology, displacement liquid as the carrier of removing material, is removed interior metabolism product, poisonous substance on the one hand, and the material that lacks on the other hand can added body is as bicarbonate etc., to keep homeostasis.The commercially available displacement liquid that uses clinically is generally by sodium at present, potassium, calcium, the lactate solution that magnesium and glucose are formed, because MODS patient often is in unsettled metabolism state and (comprises acidosis, blood glucose increases, high hypokalemia, high de-agglomeration metabolism and nutritional support treatment are to metabolic influence) characteristics, this commercially available contained potassium of displacement liquid, glucose and lactate also are unwell to acidic metabolite, blood glucose, the critical patient that blood potassium has obviously increased uses, especially the patient of liver function injury causes lactic acidosis easily even increases the weight of the state of an illness.Because existing displacement liquid can not satisfy the demand to the critical patient treatment, hospital adopt displacement liquid to vary with each individual sometimes bed is other promptly joins i.e. usefulness, but its layoutprocedure is loaded down with trivial details, and has contaminated danger.
Summary of the invention
The object of the present invention is to provide a kind of blood purification base displacing liquid that can satisfy to critical patient continuous blood purification treatment needs, not only overcome bed other promptly join promptly with displacement liquid bring such as the shortcoming of polluting, layoutprocedure is loaded down with trivial details, the also convenient simultaneously quick configuration of bicarbonate clinically, do not cause lactic acidosis, hyperglycemia etc. and freeze, farthest stablize organismic internal environment.
For achieving the above object, the technical scheme taked of the present invention is:
A kind of blood purification base displacing liquid contains NaCl 607.5～742.5 mg, MgSO in per hundred milliliters of waters for injection
418～22 mg and CaCl
222.5～27.5 mg constitute the sugar-free base displacing liquid.
On the basis of above-mentioned basic components, add the glucose of 625～1250 mg, formation contains glycosyl plinth displacement liquid.
Above-mentioned base displacing liquid provided by the invention is produced according to the conventional preparation method of infusion solutions in the prior art and to be got final product.
Beneficial effect of the present invention: at patient with severe symptoms especially MODS patient's metabolic characteristic, the not labile ion component and the concentration that only keep the outer liquid basis of human body cell, as calcium, magnesium, Na ion concentration, and ANOMALOUS VARIATIONS is taken place in patient with severe symptoms's internal metabolism easily with treatment in the potassium ion, lactate and the dextrose components that need to adjust at any time rejected, and for orthoglycemic patient, on the basis of sugar-free base displacing liquid, extend again and contain glycosyl plinth displacement liquid.When the patient with severe symptoms being carried out bed side blood purification treatment, on this displacement liquid basis, suitably replenish potassium ion and bicarbonate according to patient's concrete condition, not only can satisfy the needs of critical patient personalized treatment, effectively avoid hyperkalemia, lactic acidosis, hyperglycemia etc. and freeze, farthest stablize patient's organismic internal environment.Simultaneously, also can simplify the work of configuration displacement liquid greatly, reduce the ward environment contaminated danger of configuration down.
The specific embodiment
The present invention is described in detail below in conjunction with specific embodiment.
The conventional base displacing liquid of embodiment 1()
Get NaCl 27g, MgSO
40.8g and CaCl
21g, be dissolved in an amount of water for injection after, according to the conventional preparation method of infusion solutions, through stir, prefiltration, add water for injection to full dose 4000ml, again behind end-filtration, fill in the medical plastic transfusion bag, sealing, sterilization.
The hypotonic base displacing liquid of embodiment 2()
Get NaCl 24.3g, MgSO
40.88g and CaCl
21.1g, be dissolved in an amount of water for injection after, according to the conventional preparation method of infusion solutions, through stir, prefiltration, add water for injection to full dose 4000ml, again behind end-filtration, fill in the medical plastic transfusion bag, sealing, sterilization.
Embodiment 3(height oozes base displacing liquid)
Get NaCl 29.7g, MgSO
40.72g and CaCl
20.9g, be dissolved in an amount of water for injection after, according to the conventional preparation method of infusion solutions, through stir, prefiltration, add water for injection to full dose 4000ml, again behind end-filtration, fill in the medical plastic transfusion bag, sealing, sterilization.
Embodiment 4(half glycosyl plinth displacement liquid)
Get NaCl 27g, MgSO
40.8g, CaCl
21g and glucose 25g, be dissolved in an amount of water for injection after, according to the conventional preparation method of infusion solutions, through stir, prefiltration, add water for injection to full dose 4000ml, again behind end-filtration, fill in the medical plastic transfusion bag, sealing, sterilization.
The full glycosyl plinth of embodiment 5(displacement liquid)
Get NaCl 27g, MgSO
40.8g, CaCl
21g and glucose 50g, be dissolved in an amount of water for injection after, according to the conventional preparation method of infusion solutions, through stir, prefiltration, add water for injection to full dose 4000ml, again behind end-filtration, fill in the medical plastic transfusion bag, sealing, sterilization.
Below further set forth the beneficial effect of above-mentioned base displacing liquid provided by the invention by the clinical trial example:
To continue MODS patient's 25 examples that blood purification therapy (CBP) is applied to accept for medical treatment in ICU, man's 17 examples, woman's 8 examples, average 46.4 years old, wherein: abdominal surgery postoperative 13 examples, after liver transplantation 3 examples, thoracic surgery 4 examples, sudden cardiac arrest recovery back 1 example, orthopaedics prosthetic replacement 1 example of performing the operation, severe pancreatitis 3 examples.This group patient clinical treatment situation is as follows:
In the blood biochemical analysis, each electrolyte comprises 5 routine patients of no metabolic acidosis in the normal and blood gas analysis of blood sodium, blood magnesium, blood calcium, blood potassium, and each electrolyte inspection normally but have 5 routine patients of metabolic acidosis in the blood gas analysis.
Embodiment 1Preparation conventional base displacing liquid in, add the input of another vascular access of 15% potassium chloride 8ml and 4% sodium bicarbonate 220ml(), be used for 5 routine patients of the no metabolic acidosis of blood gas analysis; Add another vascular access input of 4% sodium bicarbonate, 140～200ml(), be used for the 5 routine patients that there is metabolic acidosis in blood gas analysis.In therapeutic process,, realize clinical personalized treatment according to the consumption of sodium bicarbonate in the blood gas analysis check result adjustment displacement liquid.
Be higher than 150mmol/L or be lower than 130mmol/L for blood sodium, and all the other electrolyte and blood gas analysis inspection normal 7 routine patients (wherein having 2 routine patient's blood potassium to be higher than 6mmol/L).At first, determine displacement liquid, be higher than the 4 routine patients of 150mmol/L for blood sodium, select for use by
Embodiment 2The hypotonic base displacing liquid of preparation is lower than the 3 routine patients of 130mmol/L for blood sodium, select for use by
Embodiment 3The height of preparation oozes base displacing liquid; Secondly, look its blood potassium situation, for normokalemic 5 routine patients, add 15% potassium chloride 8ml in the base displacing liquid selected hypotonic or high the oozing corresponding with it, be higher than the patient 2 routine patients of 6mmol/L for blood potassium, add 15% potassium chloride 2ml in the base displacing liquid selected hypotonic or high the oozing corresponding with it.Another vascular access input of 4% sodium bicarbonate 220ml, and in therapeutic process, adjust potassium chloride and sodium chloride consumption in the displacement liquid according to the biochemical analysis result, make blood sodium decline (high sodium patient) or rise (low sodium patient) speed between 0.5～1.0mmol/h, make blood potassium reduce to normal level simultaneously, realize personalized treatment.
For blood glucose at 4.0～6.1mmol/L, and all the other electrolyte and blood gas analysis inspection normal 5 routine patients,
Embodiment 4In the half glycosyl plinth displacement liquid of preparation, add 15% potassium chloride 8ml, another vascular access input of 4% sodium bicarbonate 220ml(), and in therapeutic process, adjust glucose and sodium bicarbonate consumption according to blood sugar monitoring and blood gas analysis result, realize personalized treatment.
Be lower than 4.0mmol/L for blood glucose, and all the other electrolyte and blood gas analysis inspection normal 3 routine patients,
Embodiment 5In the full glycosyl plinth displacement liquid of preparation, add 15% potassium chloride 8ml, another vascular access input of 4% sodium bicarbonate 220ml(), and in therapeutic process, adjust glucose and sodium bicarbonate consumption according to blood sugar monitoring and blood gas analysis result, realize personalized treatment.
Treatment time:Each 12～72h, mean treatment 26.3h, treatment does not wait for 1～6 time according to the state of an illness; Blood flow is 150～250ml/min, adopts quiet continuously-venous blood filter (CVVH), and preceding dilution method replenishes displacement liquid, and the displacement liquid flow velocity is 2000～4000ml/h.Various treatments are not interrupted in the CBP process, comprise total parenteral nutrition support, antibiotic therapy etc.
The anticoagulant method:Heparin saline (100mg/L) preliminary filling filter and pipeline 0.5h before the CBP, reuse normal saline 1000ml flushing.The first amount of heparin 3～10mg when CBP begins, additional quantity 1～5mg/h keeps blood plasma activated partial prothrombin time (APTT) to prolong 1.5～2.0 times.Continue input by infusion pump, with no heparin method, adjust in case of necessity according to patient's clotting time and filter state.
The patient uses dosage, biochemistry and the clinical indices of dopamine to change before and after adopting the said method treatment, and is as shown in table 1.
Table 1 shows that 25 routine patients dopamine dosage in therapeutic process reduces gradually, mean arterial pressure (MAP), heart rate (HR) and oxygenation index (PaO
2/ FiO
2) all make moderate progress (P＜0.05), serum creatinine (Cr), blood urea nitrogen (BUN) descend obviously (P＜0.05) before and after the treatment, but blood mesobilirubin does not have significant change (P＞0.05); Do not find significant side effects in the treatment.
Adopt the variation of electrolyte, blood glucose and the acid-base value index of said method treatment front and back patient's body fluid, as shown in table 2.
As can be seen from Table 2, because when CBP treats, on base displacing formula of liquid basis, at any time adjust the related drugs consumption according to blood gas analysis and biochemical analysis result, when CBP finishes, not only calcium, magnesium, sodium, chlorine ion concentration are in normal range in the electrolyte, and potassium ion, residue alkali are measured also in normal range.
Clinical conclusion:The patient with severe symptoms is carried out in the other blood purification treatment process of bed in lasting blood purification therapy (CBP), adopt base displacing liquid of the present invention, and adjust potassium chloride and sodium bicarbonate consumption in the displacement liquid at any time according to blood gas analysis and biochemical analysis result, personalized configuration displacement liquid helps reducing the drug dose that boosts, stable circulation whole therapeutic process patient, improve oxygenate, patient tolerability is better, does not have serious soda acid electrolyte and blood sugar disorders, can improve patient's prognosis preferably.
Claims (2)
1. a blood purification base displacing liquid is characterized in that: contain NaCl 607.5～742.5 mg, MgSO in per hundred milliliters of waters for injection
418～22 mg and CaCl
222.5～27.5 mg constitute the sugar-free base displacing liquid.
2. blood purification base displacing liquid according to claim 1 is characterized in that: on the basis of described sugar-free base displacing liquid, add the glucose of 625～1250 mg, formation contains glycosyl plinth displacement liquid.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010258220 CN101912414A (en) | 2010-08-20 | 2010-08-20 | Blood purification base displacing liquid |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201010258220 CN101912414A (en) | 2010-08-20 | 2010-08-20 | Blood purification base displacing liquid |
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|---|---|
| CN101912414A true CN101912414A (en) | 2010-12-15 |
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| CN 201010258220 Pending CN101912414A (en) | 2010-08-20 | 2010-08-20 | Blood purification base displacing liquid |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2013026118A1 (en) * | 2011-08-25 | 2013-02-28 | Eurofarma Laboratórios S.A | Ready-to-use electrolyte formulation, ready-to-use bag, kit, uses and method for treating kidney failure |
| CN104622894A (en) * | 2014-12-19 | 2015-05-20 | 周飞虎 | Blood purifying displacement liquid |
-
2010
- 2010-08-20 CN CN 201010258220 patent/CN101912414A/en active Pending
Non-Patent Citations (3)
| Title |
|---|
| 《中国中西医结合肾病杂志》 20030820 赵志权等 连续性血液净化治疗38例MODS疗效分析 第482-484页 1，2 第4卷, 第08期 2 * |
| 《内科》 20080625 梁路生 连续性血液净化疗法治疗多脏器功能障碍综合征16例临床分析 第392-394页 1，2 第3卷, 第03期 2 * |
| 《内科急危重症杂志》 20020930 肖观清等 连续性血液净化中不同配方置换液的疗效比较 第126-128页 1，2 第8卷, 第03期 2 * |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2013026118A1 (en) * | 2011-08-25 | 2013-02-28 | Eurofarma Laboratórios S.A | Ready-to-use electrolyte formulation, ready-to-use bag, kit, uses and method for treating kidney failure |
| CN104622894A (en) * | 2014-12-19 | 2015-05-20 | 周飞虎 | Blood purifying displacement liquid |
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Application publication date: 20101215 |